Provider Demographics
NPI:1336293554
Name:MCCLUNG, HOLLY LEHMANN (MS, RD)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:LEHMANN
Last Name:MCCLUNG
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:MISS
Other - First Name:HOLLY
Other - Middle Name:MICHELE
Other - Last Name:LEHMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD
Mailing Address - Street 1:55 BOWMAN ST
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3119
Mailing Address - Country:US
Mailing Address - Phone:508-733-5592
Mailing Address - Fax:
Practice Address - Street 1:42 KANSAS ST
Practice Address - Street 2:US ARMY RESEARCH INSTITUTE OF ENVIRONMENTAL MEDICINE
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-2642
Practice Address - Country:US
Practice Address - Phone:508-233-5309
Practice Address - Fax:508-233-5833
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2550133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered